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I’m a little all over the place right now. Please forgive me. I’m craving a chocolate malt made with high quality ice cream and I’m only finally breaking radio silence to hopefully distract myself.

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I felt I had made so much progress to get back on track with my numbers, but it’s so easy to slip. Last week not so good. I missed at least two doses of my NPH, left my meter at home one day and missed nearly a whole day of testing and the corresponding bolus insulin, didn’t do a lick of physical activity outside of walking to and from my car…

I hate myself for letting myself and the little one down. I hate that I know that the MFM doctor isn’t going to be encouraging, only stern… I hate that when I’m feeling down, I only want to indulge some more… which leads us right back into the ugly cycle. Like a whirlpool, I get sucked in and down, down, down.

I can’t bottom out though. I have lil Salty to think about.

Oh little creature of gentle nudges, random cases hiccups, rolling position changes and relentless bed-time Jazzercize, I love you. You are so precious to me. I’m going to work to be the best mom I can be, which means being the healthiest I can be. I promise.

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Blood pressure has been up a bit and I’ve noticed “significant” swelling in my feet. I hadn’t noticed anything major until this last weekend. Friday at Dr. V’s office, my BP was 113/60. Not bad. I hadn’t noticed any swelling, but she did remark, oh look at your little feet! And then I noticed that yes, my flintstone feet were looking a bit more vienna sausage than usual. Hrmm… THEN all weekend, they did swell. Probably a bit because I was sedentary. It happens… so this morning at Dr. McMFM’s my BP was 130/66 and my feet, while not as badly swollen as they had been, had no defined ankle. I ask her about it and she said that 1) I had no protein in my urine (thank the heavens!), and 2) my BP is always around that number when they record it at that office… Um what? It’s usually around 115-120, at least since my sugars have been in better control and I quit my second job… I suspect it’s the White Coat Syndrome and my distrust of that office that might be a factor… but I’m still concerned.

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So yeah, I was totally at the MFM’s today… after an appointment only just Friday with the OB. Yes. It’s happening. I get to do Non-Stress Tests with them both. As in twice a week. Dr. V brought it up at my appointment with her last Friday… apparently in the transfer of my file or whatever communication they have between offices, Dr. McMFM said that she wants me doing NSTs at her office, too… as in, I should do them twice a week. Immediately. SUUUUUUUUUCK! You know it’s fishy when your own doctor is trying to explain that she wants you to just go with it and then goes to say, “I don’t know, maybe it’s the money…” WHAT? Not exactly reassuring, Dr. V.

Also, these Non-stress tests are totally stressful. Possibly contributing to why my BP was up a bit this morning. I may have mentioned that Dr. McMFM’s office has these horrible recliners that they use instead of the standard exam “table”… they’re weird. And for a person who is under 5 foot, it’s nigh impossible to get comfortable. I spent about 40 minutes while they tried to get baby “on” where I couldn’t breathe fully because my neck was thrust forward and my boobs were choking me to death. Finally a nurse had the idea to have me sit up.

Also, Salty!Baby is a night owl. She seems to be most energetic when I’m trying to sleep… at night. Not at 8:30 a.m. So they had to “buzz” her awake and made me drink two cups of cold water while trying to maintain my supine position (seriously, get some straws). Well, then she’s awake… and wants to party. They couldn’t maintain her heart rate on the monitor because she kept evading the monitor. *sigh* I was hooked up for over an hour before they could get a good tracing on her. Sad thing was, Cindy even straight up said that baby was looking good, but it didn’t count until they could clearly read that on the monitor. *facepalm* Machines are only half of medicine.

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Note to self: MFM visits correlate with whirlpools of self-loathing and neglect… remember to seek out another MFM for future pregnancies and to send critical letter via registered mail postpartum.

I saw the doctor yesterday. She’s telling me that I’ll have weekly visits which will include Non-stress Tests starting on the 15th until I deliver…

I want to tear my hair out. See, part of me knows that being scheduled to be there is just part of ‘how they do things’ – it’s cookie-cutter care. I know that this recommendation is just part of a larger recommendation for care of pregnant diabetics, and that very little takes me and my baby’s individual needs into account. And I have this budding faith in us that Salty!Baby and I don’t need this constant monitoring… But in real life, I’m not good at playing assertive. When I try, I just end up getting grumpy and passive-aggressive. And there’s a significant part of me that does worry that something could go terribly wrong and we wouldn’t catch it *in time* if I intentionally skip out on an appointment…

This inner conflict between wanting to say, “no, I won’t do this” and just submitting are driving me nuts. I also realize that I feel that if I had a condition that was a result of the pregnancy and had little to do with my health prior to conception, I wouldn’t feel so conflicted about these extra tests and doctor’s visits. I could just throw my hands up and say, “oh well, it wasn’t meant to be” and that would be it… but that’s not the case.

I’m scheduled to be at the MFM’s office this coming Friday and looking at my original appointment card, I was just supposed to be there for a download and ultrasound, but the second appointment card (their scheduling lady always gives me a new card for each appointment that I already have on the calendar in addition to the newly scheduled appointment) says “NST” so I assume that they’re going to have me do the non-stress test there too. (And I already scheduled an NST-specific appointment with them on the 15th.) I mentioned this to Dr. V and she said to go in for that one and then tell them that she’ll take over the non-stress tests afterward and to just tell them that will be the case. *sigh* I don’t like that it’s been put on me to be the one to say these things. If I’m going to the Maternal-Fetal specialist that they wanted, even though it was apparent from day 1 that the way they practice is not a good fit for me, all because they are used to communicating between the offices, you’d think that they’d already have this NST thing worked out, or that at least my OB would tell her nurse to call the MFM’s office and straighten it out. Now the onus is on me. I missed the opportunity to call after my appoint because the MFM’s office closes at noon, so I hope that I can be clear and assertive when I call on Monday and tell them what the OB wants.

If I really get to expect to do these non-stress tests once a week, then I’d at least prefer to do it at the office with the friendlier staff.

On a parting note, partially inspired by an old blog post by the Well-Rounded Mama (“You Have the Right to Decline to be Weighed”, March 26, 2010), I asked the nurse to not tell me my weight. I didn’t feel like being “difficult” by refusing to be weighed, but I realized that after last weekend’s downward spiral, I didn’t want to hear numbers. So I closed my eyes as I stepped on, she covered up the digital read-out and then simply didn’t announce the number. No one got hurt or had to exert extraordinary amounts of effort and I walked away from that moment without feeling like a sheep OR a cow. 🙂 Small victories.

P.S. I discovered The Well-Rounded Mama in the last week and I highly recommend her if you’re concerned with the way the medical establishment approaches larger patients, especially pregnant moms.

P.P.S. Navelgazing Midwife has a nice description of a non-stress test. She is a former midwife and now acts as monitrice/doula, so her blog definitely exhibits a pro-NCB viewpoint, but she’s actually quite moderate.

I’m sure that I mentioned that I had not one, but TWO doctor’s visits scheduled yesterday. I had an appointment scheduled at Dr. V’s downtown office and an appointment scheduled with Dr. Endocrine’s FNP, Jennifer. I made crazy stupid plans to work 7-9 a.m. and then if I could finish up early enough at the endocrine clinic, I’d return for a 4-6 p.m. stint. Oh Salty! You are so cute sometimes – look at you planning stuff!

I have an amazing network of friends and acquaintances. On Tuesday, when I felt so lost, I sent out a text to a few people and the recommendations for other providers came pouring in. I have one consultation appointment already set up with an OB/GYN (who’s not very close by) and I’ve narrowed down a couple of other phone numbers to call for OBs and Maternal-Fetal/Perinatal Specialists. Yay! Thank you everyone for your encouraging spirits and all the great leads.

My experience this week has really proved that I want to blog/journal throughout this pregnancy. Why aren’t there more people talking about Diabetes, especially type 2, during pregnancy? Type 2 is pandemic to our culture and we can point the finger at many reasons – cultural, nutritional, genetic – but the fact remains that the number of women who will have to navigate diabetes during their pregnancy will only grow.

So this is another call-to-arms: what are your favorite resources on diabetes in pregnancy or high-risk pregnancies? Would it be helpful if I start an Amazon.com list of books and other items that I find helpful – or would that be condescending or presumptuous?

I went to see Dr. Endocrine and he put me in the hospital for immediate I.V. insulin. Because of my medical history, insulin is going to be the best way for me to control my diabetes for the duration of my pregnancy. I was there for about 40 hours, including two nights – not bad, really. I spent the first night on the I.V. drip with insulin pump so they could get a base-line for my insulin needs and by mid-morning they were giving me shots of insulin.

The stay wasn’t scary because my providers, including Dr. Endocrine and the hospital nursing staff, were attentive and for the most part willing to work with me by explaining procedures and remaining positive for me. Personally, I need providers who are like that; some people don’t care, but I do.

The stay did make me nervous at some points. The anticipation of my experience and the fact that I had not been expecting a hospital stay made me a wreck at first! Getting to the hospital was an exercise in not lashing out my husband out of misplaced fear. At the clinic, my BP was 114/73 (booyah self doubt!) but by admission the systolic part had jumped to 153 – yikes! After I settled into my room, I was doing better and even fell asleep rather early and easily, despite the fact that there was someone checking my blood glucose every hour on the hour. I guess the stress had exhausted me. Well, by 2 a.m. I was no longer actually upset and sadly, no longer mentally spent. After that finger-stick, I couldn’t sleep for the better part of two hours! I tried repositioning myself (not easy with the I.V.) and tried watching T.V. and tried counting sheep – nothing seemed to work! I finally got to sleep, only to be woken up by a phlebotomist at a little after 4 who needed to draw blood. Good grief!

Like I said earlier, Wednesday morning, I was already off the I.V. pump. I just had to sit tight while they continued to monitor my B.G. and stick insulin in me. The day went by quickly – I was smart and packed 2 books, blank paper and my laptop (which really couldn’t catch the wifi – boo!). My husband even came over and we played card games. I had this long phone conversation with my mom.

As I was getting ready for bed, I got a phone call from my sister, Star. I hadn’t wanted to tell her right away about the pregnancy because I was so scared about these first few weeks and I knew I’d see her at Thanksgiving. I figured I’d tell her and my mom then, and afterward call my younger half-sisters (they live a few states away) and tell them, too. After that, I figured it would be safe to let it be public knowledge and I’d tell people and let my mom tell people as it came up – I’m even thinking of doing a Christmas card just for this reason. But that first weekend that I knew, I got so excited that I threw caution to the wind and told my mom and then I wanted my mom to have someone (other than me) to talk about the news with, so I told my sister. Well, Star was calling to tell me that she told my little sisters, even though she understood that it was something I wanted to share in my own time. I kept trying to tell myself that she was excited too and didn’t completely understand the position I was in, but it was really frustrating. I’ve mostly gotten over the initial frustration and anger now, but man I still don’t know if I can talk to her. Sometimes she gets immaturely impulsive and I hate it. We’ll be okay though.

Despite that, I slept fairly well and by 8 a.m. they were telling me that I was going to get out that day. Now I’m injecting myself 4 times a day and checking my blood glucose carefully – whatever I need to do to stay a free woman.

Thursday evening I went to volunteer as I usually do with a Childbirth education course that the doula group sponsors. They’re wonderful and inspiring women: the future moms and doulas, both. I don’t do much: set up snack and help fill out forms, but being there was what I needed for normalcy, especially because I wasn’t ready to go back to work the next day.

Friday was good. I slept in (FINALLY!) and made myself breakfast and didn’t go to work. I had a sono appointment at the ob/gyn group. It went well. (Please providers, there is no excuse during non-emergency procedures and testing that you can’t look your patient in the eye and introduce yourself!) I got this:

They’re trying to date me two days later than we’d originally expected, which is fine by me. There was a strong little heartbeat. ❤

I don’t know what the rest of my pregnancy and motherhood have in store for me, but seeing this just gives me a light heart. It fortifies me.